NICOLE BRUBAKER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

ACTIVE

Business

Title

DMD

First Name

NICOLE

Last Name

BRUBAKER

Business Name

NICOLE BRUBAKER DMD

Original Issue Date

11/04/2024

Effective Date

11/04/2024

Expiration Date

09/30/2027

City

LANARK

State

Zip

61046

County

CARROLL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2025